Provider Demographics
NPI:1043604804
Name:JENKS, CASSANDRA ANELISE (NP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:ANELISE
Last Name:JENKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:ANELISE
Other - Last Name:HUFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7820 N PASEO MONSERRAT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1374
Mailing Address - Country:US
Mailing Address - Phone:520-954-2943
Mailing Address - Fax:
Practice Address - Street 1:655 MONTGOMERY ST STE 810
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-2677
Practice Address - Country:US
Practice Address - Phone:844-847-8216
Practice Address - Fax:415-520-9150
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily